Abstract
BackgroundThe position of the intraocular lens (IOL) is a major factor that affects the final visual acuity after cataract surgery. However, no prospective study has compared the IOL positions associated with the sutureless intrascleral technique and the standard transscleral suturing technique. The current study compared the IOL positions in the two techniques using ultrasound biomicroscopy (UBM) in vivo.MethodsTwenty-one eyes of 21 patients were included in this observational study conducted between February and May 2015. Eleven patients underwent the sutureless intrascleral technique, and 10 patients underwent transscleral fixation with suturing. Ophthalmologic examination and UBM were performed in all patients. Optic tilt was measured in relation to the iris plane. The haptic location was defined. Mann–Whitney test and multiple linear regression were used to analyze the vertical and horizontal gradients. Significant differences were considered when p ≤ 0.05.ResultsThe most common indication for scleral fixation was a complication during phacoemulsification (81.81% in the sutureless group and 60% in the suture group). The mean vertical and horizontal tilts were, respectively, 0.24 ± 0.21 and 0.25 ± 0.19 mm in the sutureless group and 0.14 ± 0.17 and 0.23 ± 0.16 mm in the suture group. No significant differences were seen in the vertical tilt and horizontal tilt (p = 0.888 and p = 0.148, respectively) between the groups. Gender (p = 0.835), age (p = 0.888), follow-up time (p = 0.915), and surgical duration (p = 0.094) were not associated with optic tilt. Of the 22 haptics in the sutureless group, 21 (95.45%) were in the intrascleral tunnel; of the 20 haptics in the suture group, 13 (65%) were posterior to the ciliary body, four (20%) anterior to the ciliary body, and three (15%) in the ciliary sulcus.ConclusionThis study showed that there are no significant differences in the IOL positions between the two techniques.
Highlights
The position of the intraocular lens (IOL) is a major factor that affects the final visual acuity after cataract surgery
The basic principle of this technique, which is common to most variations described in the literature, is incarceration of the IOL haptics in a scleral tunnel parallel to the limbus [1, 5]
In the sutured transscleral fixation group, we found the haptics in three positions, i.e., anterior to the ciliary body, posterior to the ciliary body, and in the ciliary sulcus
Summary
The position of the intraocular lens (IOL) is a major factor that affects the final visual acuity after cataract surgery. No prospective study has compared the IOL positions associated with the sutureless intrascleral technique and the standard transscleral suturing technique. A fundamental step in cataract surgery to optimize visual rehabilitation is implantation of an intraocular lens (IOL) after successful extraction of the crystalline lens [1]. When the capsular support is insufficient, the IOL can be implanted in the anterior chamber, fixated in the iris, or fixated in the ciliary sulcus by a transscleral suture [1,2,3]. The basic principle of this technique, which is common to most variations described in the literature, is incarceration of the IOL haptics in a scleral tunnel parallel to the limbus [1, 5]
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